| DAY 1: THURSDAY, JUNE 20, 2024 |
Conference Day 1 Opening
CCRAN works for and with patients to support their cancer care journeys. Through its advocacy, education, and research initiatives CCRAN strives to address challenges that impede optimal delivery of cancer care and patient outcomes in Canada. Timely access to biomarker testing results is one of these important challenges. This year's Biomarker Conference will build on the program of the 2023 inaugural Conference. Over the course of two days we will again convene clinical, research, policy and patient experts from across multiple cancer types to delve deeper into the access issues in Canada.
Welcome from CCRAN's President
Precision medicines are guided by a tumour's biomarker status and represent a tremendous advancement in cancer treatment. They offer new hope, but systemic barriers to accessing biomarker testing and results need to be addressed. Care and treatment gaps identified by patients served as the impetus for this Conference series.
This year's program will cover multiple cancer types: Experts from within and outside of Canada will contribute knowledge and perspectives on opportunities for ameliorating access to biomarker testing and precision medicines in service of improving cancer patient care trajectories and outcomes.
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Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
Allen Chankowsky
Patient expert; Best-selling & multi-award-winning author, patient advocate, AllenChankowsky.com
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Barriers and Unequal Access to Timely Molecular Testing Results: Addressing the Inequities in Cancer Care Delays Across Canada
In 2023, CCRAN hosted their first pan-tumour Biomarkers Conference which highlighted the importance of timely biomarker testing across cancer types and addressed the barriers that patients and clinicians experience in accessing results in a timely manner to inform treatment decision-making. The objectives, outcomes of expert discussions, and calls to action from this inaugural event are summarized in a published paper (Current Oncology). They highlight the pertinence of broader application of biomarker testing and genomic profiling in optimizing cancer care. This year's Conference builds on the objectives and outcomes of the inaugural event. Dr. Stephanie Snow, co-author, will speak to the objectives and key themes that arose from the 2023 Conference sessions.
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Dr. Stephanie Snow, MD, FRCPC
Medical Oncologist, QEII Health Sciences Centre; Professor, Faculty of Medicine, Dalhousie University; President, Lung Cancer Canada
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Results of a National Pan-Tumour Survey Regarding Access to Biomarker and CGP Testing Results: What are Canadian Advanced Cancer Patients Saying?
CCRAN is leading a collaborative research project on the patients' lived experience and outcomes related to accessing biomarker testing and results as well as comprehensive genomic profiling to better understand the benefits of facilitating access in Canada from the patient perspective across cancer types.
Working with multiple advocacy groups representing a number of cancer types, CCRAN is promoting cross-learning and building capacity for system-level and policy changes required to optimize access to genomic profiling throughout the care trajectory and thereby patient outcomes.
This research will also identify patient and healthcare provider knowledge gaps and education needs to help inform knowledge translation efforts, support patient engagement and advocacy efforts, and for developing evidence-based clinical practice guidelines for biomarker testing across cancer types. The patient information will be related to healthcare system elements, infrastructures and initiatives at the province-level to help identify policies and best practices for building capacity for optimizing access to genomic testing.
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Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Cassandra Macaulay, BSc, MHS, RTNM
Senior Manager of Programs & Education, CCRAN
Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
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Collaborative Advocacy Strategies for Addressing Biomarker Testing Access Issues Across Tumour Types
This roundtable will engage leads from patient groups representing different cancer types in a dialogue on strategic opportunities for addressing some of the issues highlighted by the results of the National pan-tumour survey on access to biomarker testing. The cancer group leads will elaborate on the survey findings from the perspective of their respective patient population.
The dialogue will serve to emphasize priorities for advocacy efforts and identify opportunities for strategic collaborations aimed at promoting timely access to biomarker testing and precision therapies. The discussion will also hone in on the value, collection, and utility of patient reported data for generating real world evidence and informing research and advocacy efforts. Patient group perspectives on questions related to data registries, including those related to governance, funding, and data sharing concerns (privacy and ethics), will be addressed.
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Patient Group Roundtable:
Martha Raymond, MA, CPN (Moderator)
Founder/CEO, The Raymond Foundation; Founding Executive Director, GI Cancers Alliance Inc. (US)
Patient Organizations:
Teresa Norris
Cervical Cancer. Founder and President, HPV Global Action
Richelle Laturnus, BSc
Prostate Cancer. Support Services Manager, Prostate Cancer Foundation Canada
Ken Noel
Prostate Cancer.
Executive Director, The Walnut Foundation
Allen Chankowsky
Salivary Gland Cancer. Best-selling & multi-award-winning author, Patient Advocate, AllenChankowsky.com
Martine Elias
Myeloma/Blood Cancers. Executive Director, Myeloma Canada
Brenda Clayton, MN
Liver Cancer (hepatocellular carcinoma and cholangiocarcinoma). Founder, Cholangio-Hepatocellular Carcinoma Canada
Maura Cosgrave
Childhood Cancers. ACCESS/PROFYLE and Childhood Cancer Canada
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Health Break
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Educational Videos
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Tackling the Implementation Gap for the Uptake of Advanced Molecular Testing into Healthcare Systems: What are the Priorities?
Advanced molecular testing, specifically comprehensive genomic profiling (CGP), enables timely and accurate cancer diagnosis and enables the selection of the most appropriate treatment options for patients. Access to next generation sequencing (NGS) technologies, however, is currently very limited in Canadian jurisdictions, depriving patients of the benefits afforded by innovations in precision medicine.
This session brings together the perspectives of Canadian and international experts in genomics, health technology assessment, laboratory medicine, and health policy in a discussion on key priorities for promoting the implementation of NGS in clinical practice in service of optimizing patient care and treatment outcomes.
Canadian experts will speak to the current state of readiness for advanced molecular testing across provinces; structural, operational and regulatory challenges with respect to implementation and equitable access; and practical opportunities for narrowing the implementation and access gap. A genomics expert from Europe will elaborate on current utilization of NGS and CGP in oncology, access challenges, as well as strategies being used to accelerate and expand the delivery and uptake of personalized medicine and diagnostics in EU member states.
Promising models and funding approaches for more collaborative and rapid implementation of CGP in healthcare systems to optimize patient access to precision medicine will be considered.
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Panel Session
Dr. Yvonne Bombard, PhD (Moderator)
Canada Research Chair in Genomics Health Services and Policy; Associate Professor, IHPME, UofT; Director, Genomics Health Services Research Program & Scientist, LKSKI, St. Michael's Hospital, UHN; Co-Founder & CEO, Genetics Adviser
Dr. Denis Horgan, PhD, LLM, MSc, BCL
Executive Director, European Alliance of Personalised Medicine (EAPM); Editor in Chief, Public Health Genomics Journal; Stakeholder Advisory Group Chair, International Cancer Genome Consortium
Dr. Laura Weeks, PhD
Director, Health Technology Assessment Canadian Agency for Drugs and Technologies in Health
Dr. Alan Spatz, MD, MSc
Professor, Departments of Pathology and Oncology, McGill University; Chief, Department of Clinical laboratory medicine, McGill University Health Center (MUHC); Medical director, Optilab Montreal-MUHC network
Dr. Michael Mengel, MD
Chair & Medical Director, Laboratory Medicine & Pathology, University of Alberta; Medical Director, Alberta Precision Laboratories Ltd.
Craig Ivany, MBA
Chief Provincial Diagnostic Officer, Provincial Health Services Authority (PHSA), British Columbia
Dr. Harriet Feilotter, PhD, FCCMG
Division Head, Genome Diagnostics, Laboratory Medicine Program, University Health Network; Service Chief, Laboratory Genetics, Kingston Health Sciences Centre; Professor (Adjunct), Department of Pathology and Molecular Medicine, Queen's University
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Health Break
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Educational Videos
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Delivering on the Promise of Precision Oncology: Efficacy and Turn-Around Time for Biomarker Testing
Precision cancer care is contingent on laboratory-based biomarker testing, with optimal treatment decisions being predicated on biomarker data. However, significant gaps in biomarker delivery exist in Canada's publicly funded healthcare system, with patients and clinicians waiting too long to receive biomarker test results, often rendering them meaningless to guide precision medicine.
Implementation of "better practices" for biomarker testing and reporting opens the door for equitable access to precision medicine, facilitating access to optimal treatment options that ameliorate patient care trajectories.
In this session, Canadian medical and laboratory experts will describe evidence-based practices for improving the timely delivery, and thereby utility, of accurate and reliable cancer biomarker results. While acknowledging the complexities of next-generation sequencing (NGS) methodologies, funding constraints, and infrastructural obstacles, experts will address challenges within the molecular diagnostic pathway, from sample collection to reporting of results, with a focus on optimizing the efficiency and quality of pathological laboratory processes and procedures. The critical role of systematic quality assurance in molecular diagnostics will be explained, and a novel end-to-end proficiency testing approach showcased. Advantages of standardizing laboratory processes within and across provinces in Canada in improving timely and equitable access to quality diagnostics and optimal treatment options will be considered.
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Presentations & Panel Session
Dr. Shaan Dudani, MD, MBChB, MPH, FRCPC (Moderator)
Medical Oncologist, William Osler Health System; Assistant Professor, University of Toronto
Experts
Emmanuelle Langelier
Caregiver to her husband, stage 4 rectal cancer patient
Dr. Brandon Sheffield, MD, FRCPC
Medical Director of Advanced Diagnostics, William Osler Health System; Mississauga Halton Central West Regional Pathology Lead
Dr. Harriet Feilotter, PhD, FCCMG
Division Head, Genome Diagnostics, Laboratory Medicine Program, University Health Network; Service Chief, Laboratory Genetics, Kingston Health Sciences Centre; Professor (Adjunct), Department of Pathology and Molecular Medicine, Queen's University
Dr. Stephen Yip
Associate Professor, UBC; Clinician-Scientist, Neuropathologist, BCCA; Associate Member at Canada's Michael Smith Genome Sciences Centre
Dr. Michael Carter, MD, PhD, FRCPC
Medical Director, Molecular Diagnostics, Nova Scotia Health; Medical Director of Research, Division of Anatomical Pathology; Co-Chair, Molecular Oncology Diagnostic Testing Provincial Stewardship Committee for Nova Scotia Health
Dr. Nicola Normanno, MD
Scientific Director, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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The Utility and Feasibility of Comprehensive Genomic Profiling (CGP) in Clinical Practice
Medical experts, specializing in colorectal, breast, lung, gynecologic, and pancreatic, cholangiocarcinoma and liver cancers, will engage in a dialogue on the value of comprehensive genomic profiling (CGP) in clinical practice, in terms of current benefits and untapped opportunities.
This session will highlight differences in how CGP is being accessed and used in diagnostic and treatment care pathways across cancers and Canadian jurisdictions. Educational needs and strategies for expanding clinician utilization of CGP will be addressed, with a focus on what it will take to implement CGP as a standard of care for advanced cancer patients in Canada. Benefits of CGP and management of patient expections with respect to treatment results and health outcomes will be considered.
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Clinician Roundtable:
Dr. Christopher Lieu, MD (Moderator)
Associate Professor, Director, GI Oncology, University of Colorado
Experts:
Dr. Michael Raphael, MD, FRCPC
Medical Oncologist, Odette Cancer Center at Sunnybrook Health Sciences Centre
Dr. Mita Manna, MD, FRCPC
Medical Oncologist, Provincial Disease Site Lead for Breast Malignancies, Saskatoon Cancer Centre
Dr. Shaqil Kassam, MD, MSc, FRCPC
Medical Oncologist, Southlake Stronach Regional Cancer Centre
Dr. Neesha Dhani, MD, PhD, FRCPC
Staff Medical Oncologist, Clinician-Investigator, Gynecologic Cancers Disease Site Group, Medical Director, Inpatient Services, UHN - Princess Margaret Cancer Centre, Division of Medical Oncology & Hematology
Dr. Ravi Ramjeesingh, MD, Ph.D, FRCPC
Medical Oncologist & Assistant Professor; Chair of the HPB Cancer Disease Site Group Halifax, Division of Medical Oncology and Department of Community Health and Epidemiology, Nova Scotia Cancer Centre & Dalhousie University
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Closing Remarks
Call to action on policy priorities for biomarker testing and reporting in oncology.
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Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
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| DAY 2: FRIDAY, JUNE 21, 2024 |
Conference Day 2 Opening
Welcome from CCRAN's President (Day 2)
Recap of Conference Day 1.
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Dr. Monika Slovinec D'Angelo, Ph.D.
VBHC Expert, Chief Research Officer, CCRAN
Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
Laura Greer
Patient Expert; Senior Vice President and National Health Sector Lead, Health and Wellness, Hill & Knowlton; Breast cancer advocate
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Equitable Access to Genomic Medicine in Canada: Bridging the Divide Between What Could be and What is through Investment and Communication Strategies
Genomic biomarkers are a cornerstone of progress in cancer treatment. Canada's healthcare system, however, is not ready for where science is taking us and lags in enabling patient access to advancements in genomic medicine. This session highlights two calls to action to bridge the gap between scientific progress and patient access to its clinical application. Namely, strategic investment in genomic testing infrastructure and rollout of targeted communication strategies.
A genomic scientist will discuss biomarker testing's transformative potential in oncology, current gaps in patient access to scientific discoveries, and opportunities for enhancing equitable access. A communications professional will speak to the role of advocacy in improving access to optimal care, and elaborate on strategies for bolstering individual and system-level advocacy efforts through education and evidence-based information sharing. Both experts bring personal experiences as cancer patients navigating cancer testing and treatment.
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Panel Session:
Dr. Monika Slovinec D'Angelo, Ph.D. (Moderator)
VBHC Green Belt, Expert, Chief Research Officer, CCRAN
Laura Greer
Senior Vice President and National Health Sector Lead, Health and Wellness, Hill & Knowlton; Breast cancer advocate
Dr. Catalina Lopez-Correa, MD, PhD
Chief Scientific Officer, Genome Canada
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The Utility and Feasibility of ctDNA Testing for Minimal Residual Disease (MRD) in Optimizing Cancer Care in Adjuvant & Metastatic Disease Settings
This session will engage medical experts, specializing in lung, breast, and colorectal cancers, and MSI high disease, in a discourse on the value and practical utility of ctDNA in adjuvant and metastatic disease settings. Focus will be on detection of minimal residual disease (MRD) for cancer types where treatment decisions and the patient care trajectory may benefit from ctDNA testing.
Medical experts practicing in Canada, Europe and the US will speak to current guidelines and application of ctDNA testing in clinical care. The use of ctDNA testing for MRD will be compared between jurisdictions, and its value in optimizing treatment pathways and patient outcomes elaborated on.
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Clinician Roundtable:
Dr. Sharlene Gill, MD, MPH, MBA (Moderator)
Professor of Medicine, UBC; Medical Oncologist, BC Cancer, Vancouver; President, Canadian Association of Medical Oncologists
Experts:
Dr. Pashtoon M. Kasi, MD, MS
Oncologist and Researcher, Weill Cornell Medicine and New York-Presbyterian Hospital; Director for Colorectal Cancer Research, Weill Cornell Medicine; Precision Medicine Director for Liquid Biopsy Research, Englander Institute of Precision Medicine
Prof. Klaus Pantel
Chairman, Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf (UKE)
Dr. Christine Brezden-Masley, MD, PhD, FRCPC
Senior Practicing Medical Oncologist and Medical Director, Cancer Program, Sinai Health System; Director, Marvelle Koffler Breast Centre, Sinai Health System; Associate Professor, Temerty Faculty of Medicine, University of Toronto; Associate Scientist, Lunenfeld-Tanenbaum Research Institute
Dr. Michael Raphael, MD, FRCPC
Medical Oncologist, Odette Cancer Center at Sunnybrook Health Sciences Centre
Dr. Joao Paulo Solar Vasconcelos, MD
Gastrointestinal Medical Oncology Fellow, BC Cancer, Vancouver
Dr. Ceilidh MacPhail, MSc, MD
Medical Oncologist, Nova Scotia Cancer Center
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Research into Practice: Biomarker Driven Patient Education Tools
Patient education and understanding of the implications of biomarker testing will be discussed in this session. Patient education experts will present on biomarker-driven online tools presently available for patients. An epidemiologist will speak to the findings from a research study evaluating colorectal cancer patients' perspectives and attitudes towards biomarker testing.
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Presentations:
Dr. Yvonne Bombard, PhD
Canada Research Chair in Genomics Health Services and Policy; Associate Professor, Institute of Health Policy, Management and Evaluation, University of Toronto; Director, Genomics Health Services Research Program & Scientist, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Co-Founder & CEO, Genetics Adviser
Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
Dr. Mary De Vera, B.Sc., M.Sc., Ph.D.
Epidemiologist; Associate Professor, UBC; Tier 2 Canada Research Chair in Health Outcomes and Treatment Adherence
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Health Break
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Educational Videos
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Examining Policy Recommendations for Accelerating Access to Precision Medicine through a Value-Based Healthcare Lens
Health system transformation experts will elaborate on the issue of equitable access to advanced molecular diagnostics and precision therapies, and the meaning of value from a healthcare expenditure and population health perspective. The value and cost of improving equitable access to precision medicine will be examined through the lens of patients, healthcare providers, population health, and health systems. The role of private industry, health technology assessment bodies, and payers in delivering on the promise of precision medicine will be considered.
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Panel Session:
Dr. Monika Slovinec D'Angelo, Ph.D. (Moderator)
VBHC Green Belt Expert, Chief Research Officer, CCRAN
Experts:
Fred Horne, ECA, MBA
Principal, Horne and Associates, Health Policy Consultants; Canadian Health Policy Consultant; Former Alberta Minister of Health
Dr. Darren Larsen, MD, CCFP, MPL
Chair, Cancer Quality Council of Ontario; Board Director, Canadian Partnership Against Cancer; Senior fellow, Women's College Hospital Institute for Health System Solutions and Virtual Care; Lecturer, Department of Family and Community Medicine and Institute for Health Policy Management and Evaluation, University of Toronto
Dr. Denis Horgan, PhD, LLM, MSc, BCL
Executive Director, European Alliance of Personalised Medicine (EAPM); Editor in Chief, Public Health Genomics Journal; Stakeholder Advisory Group Chair, International Cancer Genome Consortium
Dr. David J. Stewart, MD
Professor of Medicine, Division of Medical Oncology, University of Ottawa and The Ottawa Hospital
Jenn Gordon
Lead, Strategic Operations and Engagement, Rethink Breast Cancer
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The Interplay Between Genomic Profiling and Real-World Evidence in Precision Medicine: Optimizing Cancer Care and Facilitating Payer Decisions
This discussion will elaborate on the business case for optimizing access to precision medicine that Canadian Health Advocate, Louise Binder, co-authored, with a deep dive into how real-world evidence is generated and used to accelerate access to precision therapies in service of improving clinical care and patient-reported outcomes.
Panelists will speak to how real-world evidence (RWE) can be collected and leveraged to guide clinical and payer decision-making, and conversely how providing earlier access to genomic profiling and precision therapies is required to generate reliable RWE. Within this context, the role and practical implementation of managed entry agreements will also be elaborated on, with reference to some successful examples from Canada and international jurisdictions.
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Panel Session:
Dr. Monika Slovinec D'Angelo, Ph.D. (Moderator)
VBHC Green Belt Expert, Chief Research Officer, CCRAN
Experts:
Louise Binder, B.A., LL.B, LL.D (hon ), O.Ont.
Health Advocate and Health Policy Consultant, CONECTed - Save Your Skin Foundation
Dr. Shaqil Kassam, MD, MSc, FRCPC
Medical Oncologist, Southlake Stronach Regional Cancer Centre
Dr. Jason Karamchandani, MD
Associate Professor, Departments of Pathology, Neurology and Neurosurgery, McGill University; President, Canadian Association of Pathologists
Sang Mi Lee, MBA, BSc Phm, RPh
Executive Director, MORSE Consulting Inc.
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Feasible Opportunities to Adopt Comprehensive Genomic Profiling in Canada: An International Perspective
Experts in the field of genomic medicine will engage in a dialogue on how the use of genomic profiling in clinical practice has evolved, and the opportunities for broader application of comprehensive genomic profiling (CGP) given advancements in technology and precision medicine. The tension between system-level capacity issues (e.g., costs, training, guideline development and translation into practice, infrastructure and standardizing processes) and the inherent value to patient care and outcomes will be elaborated on to identify priorities for practical solutions. Perspectives and insights from experts in Canada, Australia, and the US will be represented.
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Panel Session:
Don Husereau, BSc Pharm, MSc (Moderator)
Adjunct Professor of Medicine, University of Ottawa
Experts:
Prof. David M. Thomas
Director, Centre for Molecular Oncology, University of New South Wales; Head of the Genomic Cancer Medicine Laboratory, Garvan Institute of Medical Research; CEO of Omico
Dr. Shantanu Banerji, BSc(Med), MD, FRCPC
Medical Oncologist, CancerCare Manitoba, MacCharles Site; Senior Scientist, Research Institute in Haematology and Oncology, CancerCare Manitoba; Director, Precision Oncology and Advanced Therapeutics, CancerCare Manitoba; Assistant Professor, Department of Internal Medicine, Section of Haematology/ Oncology, University of Manitoba
Dr. Cathy Eng, MD, FACP, FASCO
Vanderbilt-Ingram Cancer Center, Nashville, TN; David H. Johnson Chair in Surgical and Medical Oncology; Professor of Medicine, Hematology and Oncology; Director for Strategic Relations; Co-Director, GI Oncology; Co-Leader, Gastrointestinal Cancer Research Program; Director, Young Adult Cancers Program; Co-Chair, NCI Gastrointestinal Steering Committee
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Closing Remarks
Call to action on policy priorities for biomarker testing and reporting in oncology.
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Filomena Servidio-Italiano, Hon B.Sc., B.Ed., M.A.
President & CEO, CCRAN
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